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General NPI Number Information
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NPI Number | 1043502297
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Entity Type | Individual
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Provider Name | MUNNI BIRY RPH
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Gender | Female
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Dates
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Enumeration Date | 05/06/2011
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Last Update Date | 05/06/2011
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Provider Practice Location Address
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Address Line | 25401 EASTERN MARKETPLACE PLZ STE 150
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City | CHANTILLY
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State | VA
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Zip | 20152-5782
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Country | US
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Telephone | 703-722-2389
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Fax | 703-327-0382
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Provider Business Mailing Address
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Address Line | 2457 FOX STREAM LN
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City | HERNDON
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State | VA
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Zip | 20171-3049
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Country | US
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Telephone | 703-793-9013
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 0202207662
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License Number State | VA
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